Ma Grace My, Chow Jeanne S, Taylor George A
Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02215, USA.
Pediatr Radiol. 2019 Apr;49(4):534-550. doi: 10.1007/s00247-019-04371-y. Epub 2019 Mar 16.
Paraneoplastic syndromes are defined as clinical syndromes that are not related to direct tumor invasion or compression but are secondary to tumor secretion of functional peptides/hormones or related to immune cross-reactivity with normal host tissue. Paraneoplastic syndromes have a wide range of presentations and can present before the primary malignancy or tumor recurrence is diagnosed. They can mimic non-neoplastic processes, making detection, diagnosis and treatment difficult. However, they can also provide clues to the presence of an underlying malignancy. In this paper, we reviewed a range of paraneoplastic syndromes that can occur in children including: (1) neurologic (opsoclonus-myoclonus, limbic, anti-N-methyl-d-aspartate [NMDA] and anti-Ma2 encephalitis and myasthenia gravis); (2) endocrine (neuroendocrine tumors, hypercalcemia, SIADH [syndrome of inappropriate antidiuretic hormone secretion], osteomalacia/rickets and ROHHAD [rapid onset of obesity, hypoventilation, hypothalamic dysfunction and autonomic dysregulation]); and (3) dermatologic/rheumatologic syndromes (hypertrophic osteoarthropathy and paraneoplastic pemphigus). Familiarity with these syndromes can aid in early diagnosis, treatment and imaging optimization.
副肿瘤综合征被定义为并非由肿瘤直接侵袭或压迫引起，而是继发于肿瘤分泌功能性肽/激素或与正常宿主组织的免疫交叉反应相关的临床综合征。副肿瘤综合征有多种表现形式，可在原发性恶性肿瘤或肿瘤复发被诊断之前出现。它们可能类似非肿瘤性疾病过程，导致检测、诊断和治疗困难。然而，它们也可为潜在恶性肿瘤的存在提供线索。在本文中，我们综述了一系列可能发生在儿童中的副肿瘤综合征，包括：（1）神经系统（眼阵挛-肌阵挛、边缘叶、抗N-甲基-D-天冬氨酸[NMDA]和抗Ma2脑炎以及重症肌无力）；（2）内分泌（神经内分泌肿瘤、高钙血症、抗利尿激素分泌异常综合征[SIADH]、骨软化症/佝偻病以及快速肥胖、通气不足、下丘脑功能障碍和自主神经失调综合征[ROHHAD]）；以及（3）皮肤/风湿性综合征（肥大性骨关节病和副肿瘤性天疱疮）。熟悉这些综合征有助于早期诊断、治疗和优化影像学检查。
